| NPI | 1306238654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 31544.1227) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 28154600A) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |