| NPI | 1922626654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 9157) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 080929) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2021-05-03 |