| NPI | 1083734586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN128930) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN128930) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2014-09-09 |