| NPI | 1770191777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1856882) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 9639-33) | |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2024-11-11 |