| NPI | 1407283229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 18600) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN165910) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: SC 18600) | |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2020-10-13 |