| NPI | 1114172020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA TP002073D) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380333-1) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2012-08-29 |