| NPI | 1821612433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: ND R42721) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND R42721) |
| 163WP0200X Registered Nurse Pediatrics (Licence: MN 2464309) | |
| Enumeration Date | 2020-05-31 |
| Last Update Date | 2023-01-26 |