| NPI | 1942831219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79231-062) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 53-79231-062) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79231-062) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2023-02-14 |