| NPI | 1578233169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 10004790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201909224RN) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2023-06-28 |