| NPI | 1346767563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10031857) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200242161RN) |
| 363L00000X Nurse Practitioner (Licence: ID TEMP65149) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2026-05-07 |