| NPI | 1689689192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 200350089NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 098006824RN) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-12-20 |