| NPI | 1770093213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 227739) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA Rn227739) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-02-03 |