| NPI | 1295086346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5007999) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 005355) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NY F382349) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2021-08-20 |