| NPI | 1013715648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2025002971) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-84025-042) |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |