| NPI | 1336446657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP06404) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA RN102900) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-04-29 |