| NPI | 1871592162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 17973) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC ARNP 17973) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA TP0059570) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC ARNP 17973) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-06-22 |