| NPI | 1366778367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN260988) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 2000950157NP) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60987833) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2022-10-06 |