| NPI | 1558556605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0000053) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 1076) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2014-01-28 |