| NPI | 1285630657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL ARNP 2786372) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL AP2694) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-05-12 |