| NPI | 1922772516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5014840) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5014840) |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-11-15 |