| NPI | 1508466038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5013728) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5013728) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-30 |