| NPI | 1235507963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 201809676NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95001123) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2018-11-15 |