| NPI | 1912524760 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 263369) | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MA 2278737) | 
| Enumeration Date | 2020-06-28 | 
| Last Update Date | 2025-03-07 |