| NPI | 1164400453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 005784) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-55503) |
| 163W00000X Registered Nurse (Licence: MS R864584) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2014-10-21 |