| NPI | 1255705000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-130759) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1130759) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2020-04-22 |