| NPI | 1740872985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 10674) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP023223) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2024-12-24 |