| NPI | 1922159656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 45587) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 098673) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2015-04-15 |