| NPI | 1396464152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10022031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201242331RN) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2024-11-19 |