| NPI | 1689279044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024185426) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-168435) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2022-10-06 |