| NPI | 1669801858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP02288) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM GP-01143) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2021-09-03 |