| NPI | 1477120392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP023842) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP023842) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-02-23 |