| NPI | 1366512097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN0116185) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN120010) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN120010) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2014-09-17 |