| NPI | 1720393325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2010006170) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 75846) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2022-07-21 |