| NPI | 1831456169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-048222) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-048222) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-12-04 |