| NPI | 1407566771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10006717) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201907141RN) |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2023-12-05 |