| NPI | 1750857090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201810091NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 59263) |
| Enumeration Date | 2018-10-14 |
| Last Update Date | 2019-01-28 |