NPI | 1558968594 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202212410NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201240897RN) |
Enumeration Date | 2020-10-02 |
Last Update Date | 2023-07-20 |