| NPI | 1295363174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 17997-33) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 35122) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TN 35122) | |
| 163W00000X Registered Nurse (Licence: MO 2016019346) | |
| 163W00000X Registered Nurse (Licence: AL 1-172565) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-04-06 |