| NPI | 1689979916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A104144) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C-104144) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2018-11-21 |