| NPI | 1245768662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: WI 20227463) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 226174) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WI 7420) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2023-07-10 |