| NPI | 1568400695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 20895) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 20895) |
| 363L00000X Nurse Practitioner (Licence: NC 5001611) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 38354) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-03-26 |