| NPI | 1154007698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2019026953) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 12332) |
| 163W00000X Registered Nurse (Licence: CT 209287) | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-10-03 |