| NPI | 1417136938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OR 200550135NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 200550135NP) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2017-11-06 |