| NPI | 1750823076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 115169)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP9662)  | 
| Enumeration Date | 2016-11-17 | 
| Last Update Date | 2024-02-09 |