| NPI | 1083207005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 905637) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 910289) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2022-10-26 |