| NPI | 1508281619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C118529) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 118529) |
| 363L00000X Nurse Practitioner (Licence: IA C118529) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2022-03-09 |