| NPI | 1447505904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 347696-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 3476964405) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2022-12-12 |