| NPI | 1336575133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 005460) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5460) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2015-08-06 |