| NPI | 1710760103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10063561) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201703283RN) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2026-07-24 |