| NPI | 1407069388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 1059) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 683297) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2012-08-30 |