| NPI | 1043198567 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: AZ 222800) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 222800) |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-12-15 |