| NPI | 1063030286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 12.009184) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 154865) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2022-03-26 |