| NPI | 1033176342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 78406) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 1730) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-06-19 |