| NPI | 1891901559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5004821) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 470) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2021-04-01 |