| NPI | 1275169229 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10012856) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201704955RN) | 
| Enumeration Date | 2020-03-20 | 
| Last Update Date | 2024-03-22 |