| NPI | 1558846352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011049) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 213186) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011049) | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2021-12-03 |