| NPI | 1083954416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 75260) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX NP847716) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201401241NP-PP) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013042963) | |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2021-07-13 |