| NPI | 1760814222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: ND R31696) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ND R31696) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2019-09-12 |