| NPI | 1104638915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11035710) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035710) |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-03-20 |