| NPI | 1811578289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN279020) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN279020) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2022-09-29 |