| NPI | 1568963023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN216411) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA RN216411) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-10-11 |