| NPI | 1508751389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10053464) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 142407404405) |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-12-18 |