| NPI | 1629002639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 0094000300N3) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 94000300N3) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2021-03-09 |