| NPI | 1073498614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2025037520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020025672) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-09-09 |