| NPI | 1962702035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ARNP3142642) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP3142642) |
| Enumeration Date | 2010-10-23 |
| Last Update Date | 2013-09-23 |