| NPI | 1548634975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6727-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 176498-30) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2021-01-11 |