| NPI | 1740483551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 200450122NP) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: OR 200450123NP) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2008-08-29 |