| NPI | 1205380185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 20408) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 54-20408) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 20408) | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2023-05-24 |