| NPI | 1912051889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 201908398) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 20041589RN) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2019-09-22 |