| NPI | 1912093204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP3182252) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL ARNP3182252) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-10-05 |