| NPI | 1164853990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6351-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 222248-30) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2018-08-21 |