| NPI | 1265886485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA N361101565)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201601939NP-PP)  | 
| Enumeration Date | 2016-04-14 | 
| Last Update Date | 2020-11-04 |