| NPI | 1891787750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 1818) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-005076) |
| 363L00000X Nurse Practitioner (Licence: WY 1818) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 18496) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2024-11-08 |