| NPI | 1366418535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950006NP)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200250084NP)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 200250083NP)  | |
| Enumeration Date | 2006-02-27 | 
| Last Update Date | 2020-08-10 |