| NPI | 1639406366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN160542) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN160542) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |