| NPI | 1295284743 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 134008) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 21865) | 
| Enumeration Date | 2016-09-26 | 
| Last Update Date | 2019-09-12 |