| NPI | 1659365229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71002941A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 04619) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2011-09-28 |