NPI | 1154080885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2021046369) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-80732-081) |
Enumeration Date | 2021-12-09 |
Last Update Date | 2023-10-23 |