| NPI | 1205207016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2015037404) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-76994-092) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2019-01-23 |