| NPI | 1720455660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201506113NPPP) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: OR 201506113NP-PP) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2019-02-21 |