| NPI | 1699036392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ND R26975) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R26975) |
| 363L00000X Nurse Practitioner (Licence: ND R26975) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2025-04-24 |