| NPI | 1154492650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201394419NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 404449) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: OR 201394418RN) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 3085) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2014-03-12 |