| NPI | 1316274053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2009034586) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2003016294) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2015-10-27 |