| NPI | 1346910502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C165647) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C165647) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2022-03-16 |