| NPI | 1417415738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 197976) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN197976) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2020-09-11 |