| NPI | 1386636736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200350011NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200340159RN) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-06-12 |