| NPI | 1023396314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2011022946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018035609) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2018-10-09 |