| 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 |