| NPI | 1356417448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN040606) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN040606) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |