| NPI | 1093473068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 25017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 25017) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2025-09-02 |