| NPI | 1659776482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP09680) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP 60502069) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP125210) | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2018-12-11 |