| NPI | 1891190500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9366958) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL ARNP9366958) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-28 |