| NPI | 1467175976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 114487) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 140510) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A171280) | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2025-10-30 |