| NPI | 1720531494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2016020585) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 77294) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |