| NPI | 1659724599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 119077) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701485-1) |
| 163W00000X Registered Nurse (Licence: AK 117163) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2017-02-28 |