| NPI | 1245014398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 10014456) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OR 201704785RN) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2025-04-09 |