| NPI | 1043803968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024185847) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001254680) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2022-11-28 |