| NPI | 1407616568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 55187) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 202427228) |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-04-14 |