| NPI | 1215554068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202009555NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 237887) |
| 163W00000X Registered Nurse (Licence: OR 201700591RN) | |
| Enumeration Date | 2020-06-28 |
| Last Update Date | 2021-04-03 |