| NPI | 1356681761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA RN117351 AP07203) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP07203) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: LA RN117351 AP07203) | |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2021-05-20 |