| NPI | 1104572122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 5018319) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5018319) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2023-12-06 |