| NPI | 1780025270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006322) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 208865) |
| 163W00000X Registered Nurse (Licence: NC 208865) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-02-01 |