| NPI | 1568451383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200950121NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200950121NP) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2013-05-20 |