| NPI | 1417476839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5015022) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN209473) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-08-22 |