| NPI | 1811011174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 088006229N1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OR 088006229N1) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2011-03-03 |