| NPI | 1942667563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6849-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 113312-30) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-03-03 |