| NPI | 1528562899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: ID 58448) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID N-31500) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-05-18 |