| NPI | 1366807711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-136901) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-136901) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2019-04-15 |