| NPI | 1154703858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-APRN-LIC-100870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 44910) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2021-12-14 |