| NPI | 1114281284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201401668NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 21982) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60452754) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2014-12-03 |