| NPI | 1932865722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 9802) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9802-33) |
| 163W00000X Registered Nurse (Licence: WI 223863-30) | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-23 |