| NPI | 1487704813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201150126NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 098006828RN) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-09-01 |