NPI | 1255531638 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201250005NP) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OR 201142758RN) |
163WP0200X Registered Nurse, Pediatrics (Licence: OR 201250005NP) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 220) | |
Enumeration Date | 2007-07-23 |
Last Update Date | 2014-03-14 |