| NPI | 1649268079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 025532-23) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101-0012248) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2014-05-20 |