| NPI | 1073172755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11002436) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11002436) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2021-10-20 |