| NPI | 1407165756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201710254NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 201709785RN) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5004889) | |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2022-08-16 |