| NPI | 1700891215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 200250049NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 098006300RN) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP30006471) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-12-01 |