| NPI | 1982761953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 084898) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45861) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2009-06-02 |