| NPI | 1679300628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR F08240391) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10026999) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-12-13 |