| NPI | 1699154336 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201601224NPPP)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201601224NP)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: UT 273393-4405)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201601224NP-PP)  | |
| Enumeration Date | 2015-05-27 | 
| Last Update Date | 2022-10-24 |