| NPI | 1508013624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 22868) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024096329) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP016439) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2019-07-25 |