| NPI | 1164189411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022028089) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR 217272) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2022-08-18 |