| NPI | 1770063661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019095) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP019095) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2024-06-12 |