| NPI | 1699093450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201901675NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 089003081RN) |
| 225700000X Massage Therapist (Licence: OR 7641) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2021-04-07 |