| NPI | 1356789465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 75944) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 75944) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013009787) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2021-04-07 |