| NPI | 1548920499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2020023132) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011025475) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2026-06-06 |