| NPI | 1467585414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 003531) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 151957) |
| 163W00000X Registered Nurse (Licence: CT 079084) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2011-12-12 |