| NPI | 1962056556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202106433NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200842440RN) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2021-07-08 |