| NPI | 1124620448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP001953) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 113367) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2023-02-02 |