| NPI | 1225763659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10026825) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200942957) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-08-09 |