| NPI | 1629457247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201603074NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 2016004367) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2020-08-08 |