| NPI | 1649423880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 228175) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 228175) |
| 364SP0200X Clinical Nurse Specialist Pediatrics (Licence: NC 228175) | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2013-07-17 |