| NPI | 1124188404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP013211) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA RN2257867) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2013-10-08 |