| NPI | 1386620763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 087006362RN) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 087006362) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2009-04-08 |