| NPI | 1336600964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011590) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011590) |
| 363L00000X Nurse Practitioner (Licence: NC 5011590) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-12-18 |