| NPI | 1093234353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R244825) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2023-08-07 |