| NPI | 1891925004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 71003203A) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 47805) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2017-08-09 |