| NPI | 1922258656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5003994) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5003994) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2023-06-30 |