| NPI | 1861482366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN10515) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: VT 1010032226) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |