| NPI | 1205081783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ARNP9219689) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 10/18/2008 04/30/20) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2010-12-09 |