| NPI | 1609375393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5010260) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010260) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2024-05-15 |