| NPI | 1205254752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: HI 2275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 92722) |
| 163W00000X Registered Nurse (Licence: HI 85067) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2018-03-26 |