| NPI | 1982304630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 10000858) |
| Additional Taxonomies | 2080P0008X Pediatrics Neurodevelopmental Disabilities (Licence: OR 10000858) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2024-03-08 |