| NPI | 1104432921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11006983) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 11006983) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11006983) | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |