| NPI | 1750064564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 202326111) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 14460-33) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-31 |