| NPI | 1417921396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 40463) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ NN048289) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2012-02-02 |