| NPI | 1093744831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R108292) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R108292) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-05-02 |