| NPI | 1154874832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 206516) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 23711) |
| 363L00000X Nurse Practitioner (Licence: DE L10047503) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2022-09-06 |