| NPI | 1942972260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202202166NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201141098RN) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2024-02-05 |