| NPI | 1679942890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11013729) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 113163) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5007990) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 3-000676) | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2025-01-23 |