| NPI | 1124078175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201600042NP) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: OR 3299 OR) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-09-13 |