| NPI | 1376168229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2020024183) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IA 139222) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-08-11 |