| NPI | 1477106730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C154088) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9421) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 9421) | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2022-06-02 |