| NPI | 1235529389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2014042984) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MO 2002016375) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2020-11-04 |