| NPI | 1174826952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5005364) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 206739) |
| 363L00000X Nurse Practitioner (Licence: NC 206739) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 20103683) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 206739) | |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2022-05-27 |