| NPI | 1518101674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 21124) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP 9405374) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN08407200) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-07-21 |