| NPI | 1710473541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201904779NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 099000229RN) |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2019-07-14 |