| NPI | 1982670576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 44148) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 13.33645.082) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2012-05-31 |