| NPI | 1922513886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID Pending) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 57631) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2018-03-17 |