| NPI | 1891902235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C-124750) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C124750) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 3172972) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-08-18 |