| NPI | 1740577576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 08120) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: CA 22300) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2015-03-04 |