| NPI | 1124596721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP019543) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP019543) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP019543) | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2024-12-23 |