| NPI | 1134862345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-179144) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN331298) |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2024-09-24 |