| NPI | 1336517317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 8115) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-150324) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2018-02-07 |