| NPI | 1760159040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5016822) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC JAME-171QX) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-03-15 |