| NPI | 1336525625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5007863) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007863) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2024-08-02 |