| NPI | 1659523520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60100863) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00173200) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2011-04-28 |