| NPI | 1386892321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 004572) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 097354) |
| 163WC1500X Registered Nurse, Community Health (Licence: WA RN00174711) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2012-11-07 |