| NPI | 1619704897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP030620) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP030620) |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-11-18 |