| NPI | 1215922166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18329) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP009557) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R107809) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2014-12-02 |