| NPI | 1588974869 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9497670) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 4317) | 
| Enumeration Date | 2010-10-20 | 
| Last Update Date | 2020-04-30 |