| NPI | 1851661508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2011035337) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-75557-021) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.008879) | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2016-09-13 |