| NPI | 1104979822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-062777) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-062777) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2023-06-30 |