| NPI | 1568082642 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5013066) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5013066) | 
| Enumeration Date | 2020-04-20 | 
| Last Update Date | 2023-05-17 |