| NPI | 1174974315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C119935) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C119935) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-12-06 |