| NPI | 1801636691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN292487) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN292487) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-09-25 |