| NPI | 1134791742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 9929) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 153113) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-09-01 |