| NPI | 1023577616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA 020127) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LJ-0010384) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2020-10-05 |