| NPI | 1588614309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111323) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 111323) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 132171) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-08-30 |