| NPI | 1245866268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-140539) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-140539) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-140539) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2021-11-30 |