| NPI | 1811363088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 8243) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2295612) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP95005716) | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2023-11-20 |