| NPI | 1790206530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 23875) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC 1017985) |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2023-03-15 |