| NPI | 1164629267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5014032) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NV APRN001528) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN965576) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-06-18 |