| NPI | 1972200822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017669) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC MANG-RH5S7) |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-04-03 |