| NPI | 1558896290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP017228) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: OH IR.0983585) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2025-02-25 |