| NPI | 1780940064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201910562NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2005024512) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012009251) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-03-30 |