| NPI | 1760610299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN187738) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 6586) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |