| NPI | 1205307881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201904775NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200641051RN) |
| Enumeration Date | 2018-12-08 |
| Last Update Date | 2019-06-18 |