| NPI | 1962700575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN1039112) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1039112) |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2019-12-26 |