| NPI | 1245321538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP004267N) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA TP004267N) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-08-07 |