| NPI | 1629147996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200650019NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 098006536RN) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA RN00047944) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-08-15 |