| NPI | 1790466605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-82293-012) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2023013077) |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-25 |