| NPI | 1104370204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP016390) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 26961) |
| Enumeration Date | 2016-08-07 |
| Last Update Date | 2024-05-29 |