| NPI | 1164042685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-173773) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-173773) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-05-17 |