| NPI | 1790567683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 14633-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 14633-33) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-11-21 |