| NPI | 1689922742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-75678) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75678) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2012029472) | |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2024-09-12 |