| NPI | 1629009659 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 088000529N1)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 088000529RN)  | 
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2018-09-27 |