| NPI | 1871503987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN208550) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN426822) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA RN426822) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2012-11-06 |