| NPI | 1033777560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24653) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 226627) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 24653) | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2021-10-29 |