| NPI | 1962127290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C171037) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 114321) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |