| NPI | 1346545860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 540) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 100529) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |