| NPI | 1649764358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP022972) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9487280) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-04-11 |