| NPI | 1861030660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11004426) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004426) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2022-09-27 |