| NPI | 1568651289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R861851) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS R861851) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2009-07-22 |