| NPI | 1669891172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP09098) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-137616) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2017-10-13 |