| NPI | 1710146790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05543) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 1883) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2025-09-30 |