NPI | 1326239195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-126782) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: OR 099007632RN) |
363LF0000X Nurse Practitioner, Family (Licence: OR 200850014np) | |
Enumeration Date | 2007-08-07 |
Last Update Date | 2021-05-10 |