| NPI | 1134862246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11029150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9367268) |
| 363L00000X Nurse Practitioner (Licence: FL 11029150) | |
| Enumeration Date | 2022-04-16 |
| Last Update Date | 2024-05-07 |