| NPI | 1104646710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R239234) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC NP500009305) |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-12-18 |