| NPI | 1538651419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL 11001734) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 24253) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2019-03-06 |