| NPI | 1063105856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10062616) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201391005RN) |
| 163W00000X Registered Nurse (Licence: OR 201391005) | |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2026-07-13 |