| NPI | 1578948170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201706683NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201406319RN) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2017-11-09 |