| NPI | 1720608599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024183126) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001282108) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2022-02-23 |