| NPI | 1154058634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11012859) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL APRN11012859) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-12-08 |