| NPI | 1194873828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN117846) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 117846) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-08-01 |