| NPI | 1902655582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2025012520) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 307244) |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2025-07-07 |