| NPI | 1114689452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11021708) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 30527) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3016740) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 30527) | |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2024-09-10 |