| NPI | 1376164152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9072) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CT 153618) |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2020-09-01 |