| NPI | 1932471018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 10192030) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 3652033) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |