| NPI | 1568617504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110987) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 110987) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 110987) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2016-11-02 |