| NPI | 1871858464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R216132) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9267954) |
| 163W00000X Registered Nurse (Licence: MD R216132) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2019-02-15 |