| NPI | 1538344239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 2741534405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 2741534405) |
| Enumeration Date | 2008-01-01 |
| Last Update Date | 2008-01-01 |