| NPI | 1063055663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-185699) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-185699) |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2022-07-14 |