| NPI | 1770099319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011666) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE LJ-0010479) |
| 363L00000X Nurse Practitioner (Licence: DE LJ-0010479) | |
| 163W00000X Registered Nurse (Licence: NC 310313) | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2024-10-07 |