| 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 |