| NPI | 1679510390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 123260) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 123260) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: MO 123260) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-09-14 |