| NPI | 1407409394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112805) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NE 112805) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2022-10-03 |