| NPI | 1477801728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 7840) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA c128075) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-07-21 |