| NPI | 1790540029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024000559) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2024000559) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-04-23 |