| NPI | 1598048878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 12.005079) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2268080) |
| 163W00000X Registered Nurse (Licence: CT 10.107616) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 005079) | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2015-07-30 |