| NPI | 1093566234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 110897) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 110897) |
| 163W00000X Registered Nurse (Licence: PA RN711336) | |
| 163W00000X Registered Nurse (Licence: CA 95318268) | |
| 363L00000X Nurse Practitioner (Licence: PA SP029245) | |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |