| NPI | 1831400829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL 9292764) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 5066) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2013-02-14 |