| NPI | 1548745169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL APRN9364919) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9364919) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-11-19 |