| NPI | 1720630429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 22960) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 22960) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2020-05-07 |