| NPI | 1801560131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5014680) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC BRIC-AZ9A6) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-09-30 |