| NPI | 1750908778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015650) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP021970) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-08-08 |