| NPI | 1902232556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2015002669) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 76725) |
| Enumeration Date | 2013-09-15 |
| Last Update Date | 2015-04-27 |