| NPI | 1730667312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9314673) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 2659524) |
| Enumeration Date | 2018-08-05 |
| Last Update Date | 2021-04-12 |