| NPI | 1225562812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R177981) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 292461) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2023-08-01 |