| NPI | 1275004491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011281) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 24445) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2022-06-28 |