| NPI | 1508216961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5016027) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MS 901612) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2024-03-06 |