| NPI | 1073693362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201810581NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP 15105) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-03-01 |