| NPI | 1790052496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL AWAITING NUMBER) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9318049) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |