NPI | 1295208254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2023018580) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-82335-032) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2023-11-21 |