| NPI | 1205200441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP015686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP015686) |
| Enumeration Date | 2015-11-28 |
| Last Update Date | 2023-12-05 |