| NPI | 1740930528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-81269-072) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: KS 13-119552-072) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022019412) | |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-06-26 |