| NPI | 1790144111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 028093-23) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 028093-23) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NH 028093-23) | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2017-01-16 |