| NPI | 1043316417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN232945) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: SC APN17983RX) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2017-01-09 |