| NPI | 1366864118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 111447) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 74823) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |