| NPI | 1669141669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 35648)  | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN259102)  | 
| Enumeration Date | 2021-09-13 | 
| Last Update Date | 2024-06-18 |