| NPI | 1003395948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011512) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024176493) |
| Enumeration Date | 2018-08-11 |
| Last Update Date | 2019-07-01 |