| NPI | 1548810559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-149829) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1149829) |
| 363L00000X Nurse Practitioner (Licence: AL 1-149829) | |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2023-03-14 |