| NPI | 1316544638 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP002687) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10443-33) | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 10443-33) | |
| Enumeration Date | 2020-10-09 | 
| Last Update Date | 2023-08-21 |