| NPI | 1962747246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C128838) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: IA 128838) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: IA 128838) | |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2018-05-02 |