| NPI | 1740776970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 0000000000000) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |