| NPI | 1811274921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2011037061) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MO 154569) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2021-11-05 |