NPI | 1497477400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022039084) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-81582-021) |
163WP0200X Registered Nurse, Pediatrics (Licence: MO 2014026080) | |
Enumeration Date | 2022-09-15 |
Last Update Date | 2022-10-09 |