| NPI | 1619680527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2023008358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-131743-122) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-81854-122) | |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-05-04 |