| NPI | 1508552829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 2661878) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-APRN-LIC-214478) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-11-06 |