| NPI | 1730593989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MS R852094) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA RN100625AP07799) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2015-04-09 |