| NPI | 1073883542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA AP06474) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA RN073409-AP06474) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2023-01-26 |