| NPI | 1326794421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP021784) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP021784) |
| 363A00000X Physician Assistant (Licence: PA SP021784) | |
| 363L00000X Nurse Practitioner (Licence: PA SP021784) | |
| Enumeration Date | 2022-02-27 |
| Last Update Date | 2022-03-09 |