| NPI | 1295110930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2015022740) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 76810) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |