| NPI | 1518154780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2015011917) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9282512) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 76782) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-06-26 |