| NPI | 1235649674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 6855746-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 6855746-4405) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-12-20 |