| NPI | 1154562049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP05787) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA RN107541) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2026-01-21 |