| NPI | 1225779002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11036480) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9645541) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-11-14 |