| NPI | 1194540641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5021265) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: NC 252353) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2025-03-24 |