| NPI | 1053088575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202111129NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201602008RN) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2022-09-14 |