| NPI | 1356986806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11004969) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL 9404458) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |