| NPI | 1962867861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5009741) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009741) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5009741) | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2023-12-18 |