| NPI | 1144780263 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN248762)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN248762)  | 
| Enumeration Date | 2019-03-24 | 
| Last Update Date | 2021-05-26 |