| NPI | 1770611121 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10021635)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 564141)  | 
| Enumeration Date | 2007-02-28 | 
| Last Update Date | 2025-01-30 |