| NPI | 1962400374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200150107NP-PP) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OR 079043485RN) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2012-10-26 |