| NPI | 1851630248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C127907) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C127907) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2015-05-11 |