| NPI | 1245651512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CO APN.0990539-NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA AP07790) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2018-03-17 |