| NPI | 1154458370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 201506666NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 15377) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-10-04 |