| NPI | 1932101854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 1730) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001730) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 001730) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2024-06-25 |