| NPI | 1891361275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C164819) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 143988) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-08-02 |