| NPI | 1669745659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS A810502) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS R868511) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A03700) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 826055) | |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2014-07-10 |