| NPI | 1447792197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 22822) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.014979) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2019-09-06 |