| NPI | 1992082325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2008023068) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2011037407) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2012-03-01 |