| NPI | 1104478270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 821588) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NV 821588) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-12-18 |