| NPI | 1851483630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024168548) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE L10019722) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE L10019722) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2011-01-12 |