| NPI | 1124796123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11034742) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9393861) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2025-09-23 |