| NPI | 1043803125 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11011563) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11011563) | 
| Enumeration Date | 2021-02-18 | 
| Last Update Date | 2022-03-31 |