| NPI | 1255049888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 0000241624) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 14113) |
| 163W00000X Registered Nurse (Licence: CT 163406) | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-11-13 |