| NPI | 1831390772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2018011775) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018040896) |
| 163W00000X Registered Nurse (Licence: NY 479405-1) | |
| 363L00000X Nurse Practitioner (Licence: TX 706774) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381465) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP124482) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2019-01-22 |