| NPI | 1114652856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MO 2022028169) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KS 53-81380-021) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-07-25 |