| NPI | 1124126164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 79312) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MO 068348) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-05-12 |