| NPI | 1730619073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2017020563) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017020563) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-12-17 |