| NPI | 1609147719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201391307NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200742940RN) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2021-12-18 |