| NPI | 1578044558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC FITZ-8HTPLZ) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC FITZ-8HPLZ) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |