| NPI | 1124486436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A114412) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA A114412) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |