| NPI | 1063567543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024167200) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME CNP181273) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-05-07 |