| NPI | 1700292166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 874618) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS r874618) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2018-07-20 |