| NPI | 1316645567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027140) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP027140) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP027140) | |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-02-17 |