| NPI | 1912483595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL APRN9266804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9266804) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2019-06-27 |