| NPI | 1366656761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 7629) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 7629) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5007843) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-03-07 |