| NPI | 1598825515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-75721-112) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 115839) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-05-29 |