| NPI | 1558701763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 111519) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 111519) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA c176958) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2025-12-01 |