| NPI | 1720503360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A005309) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR A005309) |
| 363L00000X Nurse Practitioner (Licence: AR A005309) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2019-02-18 |