| NPI | 1154387603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 183420) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN113523) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-11-17 |