| NPI | 1659519940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP 21654) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101.00072446) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4125) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 275033) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382131) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP 3252) | |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2012-11-02 |