| NPI | 1285647545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN1040416) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R220570) |
| 363L00000X Nurse Practitioner (Licence: MA 233952) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2016-06-01 |