| NPI | 1497215032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MS 904868) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 903259) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2021-11-02 |