| NPI | 1104628163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2025006573) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-84136-041) |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-03-27 |