| 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 | 2022-10-20 |