| NPI | 1205064045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 300272) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 164246) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 300272) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2015-03-11 |