| NPI | 1891079430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R187505) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024170262) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 121520) | |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2021-08-12 |