| NPI | 1891170346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5015170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0515551) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 340238) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2022-04-28 |