| NPI | 1881195196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201908654NP-PP) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR 094006399RN) |
| 2080H0002X (Licence: OR 201908654NP-PP) | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2019-11-13 |