| NPI | 1134694847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 202300) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: LA RN143418) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2019-06-11 |