| NPI | 1518482298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 20163161) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MO 2008022120) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2021-11-04 |