| NPI | 1013507581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 200550140NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 200550140NP) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-02-09 |