| NPI | 1740304948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 124767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 124767) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 000124767) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2009-03-24 |