| NPI | 1598029118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0992085) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 686638) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2019-03-25 |