| NPI | 1114958824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 149820) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA RN149820) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-05-10 |