| NPI | 1386639292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7527) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3690P) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 137261) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2023-10-10 |