| NPI | 1700503257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 1679267) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 58053) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP026310) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM 86830) | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2026-01-08 |