| NPI | 1760689202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: OR 200650082NP NMNP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 200650082NP) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2011-01-05 |