| NPI | 1063901684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5010504) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5010504) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2023-03-07 |