| NPI | 1699914630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201702906NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200742025RN) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2017-05-01 |