| NPI | 1841033677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2024021742) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-149330-021) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-83267-021) | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |