| NPI | 1609247972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201804756NP) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 201804756NP) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP129328) | |
| Enumeration Date | 2015-10-13 | 
| Last Update Date | 2025-08-15 |