| NPI | 1770679458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200050043NP) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OR 200050043NP) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA 025804AP30006101) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 200050043) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-11-09 |