| NPI | 1083950174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 19019) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 204188) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2018-11-27 |