| NPI | 1659522514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO SXP-10038) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 145595-5) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 4050) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2013-07-12 |