| NPI | 1932820842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 202213773NP-PP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 202213774NP-PP) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-11-03 |