| NPI | 1003468786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 903433) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 207187) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |