| NPI | 1992139976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R878817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS F0613716) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2014-08-28 |