| NPI | 1578048823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MS 902965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 902965) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-24 |