| NPI | 1912241860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R213671) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD AC001095) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-07-24 |