| NPI | 1124010004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R110105) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MD R110105) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP018623) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-08-03 |