| NPI | 1093320053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-157454) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 904085) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-04-19 |