| NPI | 1861752495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA TAP002869) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: LA RN112421) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-07-02 |