| NPI | 1104423136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN269388) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN269388) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2023-09-25 |