| NPI | 1174991384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 285575) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD AC001611) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2023-01-05 |