| NPI | 1104369917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 202101747NP-PP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 202101747NP-PP) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 202101747NP-PP) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60689542) | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2023-07-19 |