| NPI | 1972519429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 200550154NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 200541965RN) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-07-27 |