| NPI | 1861799165 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201605969NP-PP) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 089006788RN) | 
| Enumeration Date | 2011-02-22 | 
| Last Update Date | 2020-11-13 |