| NPI | 1114619921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL 11026420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11026420) |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2025-03-10 |