| NPI | 1720368855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MS 868611) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R868611) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MS R868611) | |
| Enumeration Date | 2011-08-20 |
| Last Update Date | 2020-04-28 |