| NPI | 1174099873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011158) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011158) |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2023-12-18 |