| NPI | 1740565779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2011034123) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 155291) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2024-10-16 |