| NPI | 1972825537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 71285) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 4938107-4405) |
| 363L00000X Nurse Practitioner (Licence: UT 4938107-8900) | |
| 363L00000X Nurse Practitioner (Licence: UT 4938107-4405) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 19447) | |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2022-04-11 |