| NPI | 1043837057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202104274NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000240871) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-06-08 |