| NPI | 1609375450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-145628) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: AL 1-145628) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2020-03-25 |