| NPI | 1669237160 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10042963) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6914624-4405) | 
| 163W00000X Registered Nurse (Licence: UT 6914624-3102) | |
| 163W00000X Registered Nurse (Licence: OR 10042963) | |
| Enumeration Date | 2024-02-14 | 
| Last Update Date | 2025-10-01 |