| NPI | 1851394464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200450048NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 53108) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 200450048NP) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2018-03-17 |