| NPI | 1083830137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 158854) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NC 158854) |
| 363L00000X Nurse Practitioner (Licence: NC 158854) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2013-09-26 |