| NPI | 1841770674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 60516) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 41738.1786) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2019-03-25 |