| NPI | 1760542039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC 62181) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC RN62181) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2012-09-07 |