| NPI | 1063962611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5018797) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 27279) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2024-10-31 |