| NPI | 1063433357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024167406) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 7799-NP) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-05-12 |