| NPI | 1942769161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011594) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC RIDI-HNOA0S) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2022-05-12 |