| NPI | 1609053800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 003207) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 438138) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2010-11-19 |