| NPI | 1790828580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 687693) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP03593) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2025-01-17 |