| NPI | 1104271030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008525) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NC 266220) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2021-11-18 |