| NPI | 1568000982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5012725) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 201914081) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2022-05-12 |