| NPI | 1407106180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 134484) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A003730) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2019-10-04 |