| NPI | 1912379934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: NC 5008153) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5008153) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2016-11-21 |