| NPI | 1376183582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C155692) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 8692305-4405) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C155692) | |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2022-02-28 |