| NPI | 1568405819 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R086221) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R086221) | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R086221) | |
| Enumeration Date | 2006-06-14 | 
| Last Update Date | 2023-10-31 |