| NPI | 1083847503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 3978) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R09336) |
| 363L00000X Nurse Practitioner (Licence: AR A004116) | |
| 363L00000X Nurse Practitioner (Licence: SC 3978) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2020-10-14 |