| NPI | 1275835530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO RXN0101155NP) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 991605) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 590290) | |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2018-09-10 |