| NPI | 1780989590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO NP-10342) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1649) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2018-03-17 |