| NPI | 1023385887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: SD CP000683) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: MN 3420) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN 3420) | |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2023-12-05 |