| NPI | 1760497515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 02384423) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 1010017995) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2011-11-15 |