| NPI | 1649261223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 097006277N1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 97006277) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2019-02-20 |