NPI | 1720134737 |
---|---|
Former Name | SHIRLEY ANN MOLITOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2006029960) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-45957-011) |
Enumeration Date | 2007-01-25 |
Last Update Date | 2024-10-29 |