| NPI | 1134648009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 223808) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 342054) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2019-12-26 |