| NPI | 1497348916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 29232) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN249862) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-12-17 |