| NPI | 1598040255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 23213) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD N72400) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2021-02-11 |