| NPI | 1255680070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN225115) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71003996A) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71003996B) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |