| NPI | 1083917751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2307014) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 16654) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9315769) | |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2017-09-20 |