| NPI | 1760685739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201407057NP-PP) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MA 176797) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2014-11-06 |