| NPI | 1285168799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R215971) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA RN670201) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |