| NPI | 1194234252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11004240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2299860) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2020-01-13 |