| NPI | 1063631083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WI 1069) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: WI 113626) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |