| NPI | 1245890482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11003127) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL RN9409241) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-07-15 |