| NPI | 1265447775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 097007252N2) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 097007252RN) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-10 |