| NPI | 1174825368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE LJ0000298) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011063) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2015-01-13 |