| NPI | 1700829892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 083038222RN) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 083038222N3ANP) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |