| NPI | 1033855804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C169399) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C169399) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA C169399) | |
| 163W00000X Registered Nurse (Licence: IA 134159) | |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-10-26 |