NPI | 1710777412 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 10045389) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202010818RN) |
Enumeration Date | 2025-05-07 |
Last Update Date | 2025-08-19 |