| NPI | 1366400293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200150108NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200150108NPFNPPP) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2015-06-05 |