| NPI | 1649712548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 240449) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 60705836) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2025-08-29 |