| NPI | 1407977887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 115307) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 115307) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-11-15 |