| NPI | 1215564091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1176184) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-176184) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2021-09-29 |