| NPI | 1275888661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5006290) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA rn224465) |
| Enumeration Date | 2012-07-21 |
| Last Update Date | 2023-09-27 |