| NPI | 1700380268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OK 82714) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 82714) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-05-31 |