| NPI | 1083207492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL 11022671) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9451695) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2024-01-10 |