| NPI | 1396304291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202008644NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201141585RN) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-10-28 |