| NPI | 1366516841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2009037134) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MD R155784) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-75070-012) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-75070-012) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2009037134) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-11-28 |