| NPI | 1235170424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 079824) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 45545) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-09 |