| NPI | 1407940521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI NPP37423) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA VP0066870) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-06-18 |