| NPI | 1629038898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 3198033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 144853) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2009-05-14 |