| NPI | 1003324245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 25549) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO APN.0993640-NP) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2022-03-07 |