| NPI | 1053950345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5012686) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 253543) |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-10 |