| NPI | 1760103964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022009228) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 5381057062) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2023-12-09 |