| NPI | 1841663945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 113174) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 13850) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95025289) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 172260) | |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2024-11-20 |