| NPI | 1780946616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9202734) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9202734) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-26 |