| NPI | 1053703132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MS R878833) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA AP09490) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2017-09-19 |