| NPI | 1750460416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 079043756NI) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 079043756N1) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2015-07-09 |