| NPI | 1619345253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-138718) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-138718) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2017-05-09 |