| NPI | 1821016965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 083038699N7) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 083038699RN) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-11-03 |