| NPI | 1427542935 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201807335NP-PP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 201807334NP-PP) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-02-03 |