| NPI | 1700963071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME AP081039) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP30006925) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-08-18 |