| NPI | 1366151110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 13375) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 223586-30) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-12-12 |