| NPI | 1396859690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-RN-LIC-68162) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 868) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2015-04-17 |