| NPI | 1154650752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT 100556) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT 91730) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2023-11-27 |