| NPI | 1750810610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7693) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7693-33) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 7693) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-12-07 |