| NPI | 1669622320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-115356) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP05789) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2020-08-25 |