| NPI | 1316105075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 97062) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WI 104212-030) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |