| NPI | 1629623871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 224936) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY F382992) |
| 208000000X Pediatrics (Licence: LA 224936) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2023-10-02 |