| NPI | 1578038899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 8770-33) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 8770) |
| 363L00000X Nurse Practitioner (Licence: WI 8770) | |
| Enumeration Date | 2018-10-13 |
| Last Update Date | 2022-06-01 |