| NPI | 1558613356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 20111693) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 86448) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2022-03-10 |