| NPI | 1629597778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202005498NP-PP)  | 
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MN 2457659)  | 
| Enumeration Date | 2017-09-10 | 
| Last Update Date | 2024-04-11 |