| NPI | 1992957146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 24123)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024164588)  | 
| Enumeration Date | 2008-10-21 | 
| Last Update Date | 2024-06-19 |