| NPI | 1417144502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71000885) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71000885) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2014-01-31 |