| NPI | 1134650955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR 201701959NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201701959NP-PP) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2020-05-20 |