| NPI | 1912130709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: IA C112122) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA C-112122) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2023-11-06 |