| NPI | 1528726205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA A187928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021044283) |
| 363L00000X Nurse Practitioner (Licence: IA A187928) | |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2025-12-10 |