| NPI | 1972886273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005377) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 216598) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5005377) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2013-06-21 |