| NPI | 1336806876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 108740) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN.25464) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-03-28 |