| NPI | 1982699658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C048985) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA 19990513) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2010-10-15 |