| NPI | 1194097261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5147) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 5147-33) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2013-04-03 |