| NPI | 1629819297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2024020248) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023168392) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-12-04 |