| NPI | 1336620061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10059197) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201230117LPN) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2026-04-22 |