| NPI | 1740743129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011681) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC FARR-CQ06KJ) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2019-06-11 |