| NPI | 1790042455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005573) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 50550073) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-08-26 |