| NPI | 1477809390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 23002) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA RN551360) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NR11282500) | |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2022-03-18 |