| NPI | 1083246474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 864754) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 865754) |
| 163W00000X Registered Nurse (Licence: MS 865754) | |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2025-03-25 |