| NPI | 1295724375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200650051NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200650051NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 090309-23) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-02-14 |