| NPI | 1134876964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 202202172NP-PP) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 202202172NP-PP) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: OR 202202172NP-PP) | |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-03-07 |