| NPI | 1356682173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-122716) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-122716) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-122716) | |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2019-03-28 |