| NPI | 1275258592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022045602) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 14-125089-112) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-12-11 |