| NPI | 1679949663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 5553-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 81557-30) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2019-10-23 |