| NPI | 1700217064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201394254NP PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201394254NP-PP) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2024-01-09 |