| NPI | 1235410804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C-128982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C128982) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2024-02-22 |