| NPI | 1306086582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 123616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 123616) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 123616) | |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2019-07-25 |