| NPI | 1003658881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 10024689) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 4861460) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2025-01-03 |