| NPI | 1255115564 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10029361) | 
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OR 200441269RN) | 
| 363L00000X Nurse Practitioner (Licence: OR 10029361) | |
| Enumeration Date | 2023-08-21 | 
| Last Update Date | 2025-08-11 |