| NPI | 1063850220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 202202378NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV APRN100899) |
| 363L00000X Nurse Practitioner (Licence: PA SP016686) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-06-03 |