| NPI | 1194278887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MO 2016021959) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KS 53-77295-042) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |