| NPI | 1477856409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201350105NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP011097) |
| 363L00000X Nurse Practitioner (Licence: CT 004792) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011097) | |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2013-06-12 |