| NPI | 1932772399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10002945) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201241027RN) |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2022-12-28 |