| NPI | 1396555652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10038520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200540315RN) |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-04-01 |