| NPI | 1306879457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NE 23658) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD 77569) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2007-07-08 |