| NPI | 1457775819 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022037507) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN150105) | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2021019303) | |
| Enumeration Date | 2014-02-05 | 
| Last Update Date | 2024-08-01 |