| NPI | 1619364106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 223952) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 223952) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2025-01-29 |