| NPI | 1992855738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R028167) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R028167) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |