| NPI | 1699483107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 317719) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 245912) |
| 208000000X Pediatrics (Licence: GA 317719) | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-11-06 |