| NPI | 1376972869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013259) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 5013259) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2024-11-13 |