| NPI | 1265028260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11011563) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11010518) |
| 363L00000X Nurse Practitioner (Licence: FL 11010518) | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2022-03-31 |