| NPI | 1558611848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017033715) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KS 14-141627051) |
| 363L00000X Nurse Practitioner (Licence: NE 111414) | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2020-12-14 |