| NPI | 1902094378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN174289NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101-0028270) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2010-10-27 |