| NPI | 1679547160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK COA.18287-NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R1137817) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2015-11-04 |