| NPI | 1417070475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 085471) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 76335) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2014-12-29 |