| NPI | 1609929124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP017882) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LJ0000280,L10042280) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2017-12-21 |