| NPI | 1336591049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-78308-011) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2016013652) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2020-03-11 |