| NPI | 1649707340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R195992) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MD R195992) |
| 363L00000X Nurse Practitioner (Licence: PA RN702012) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2023-03-30 |