| NPI | 1205427044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3015793) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3015793) |
| 363LF0000X Nurse Practitioner Family (Licence: IN 71014235A) | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2023-11-08 |