| NPI | 1154874832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024193137) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 206516) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2025-08-05 |