| NPI | 1265939185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201807766NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201807766NP) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95010714) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: OR 201807766NP) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: CA 95010714) | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2023-12-30 |