| NPI | 1174676571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 003009) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 068533) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2014-04-25 |