| NPI | 1366615635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5003952) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 176967) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2014-03-11 |