| NPI | 1205718905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R244994) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP033367) |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |