| NPI | 1134206287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 003428) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2013013677) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NE 110350) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-07-25 |