| NPI | 1437817897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383450) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 95019228) |
| 363L00000X Nurse Practitioner (Licence: CA 95019228) | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-10-12 |