| NPI | 1821624065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN265335) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN265335) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2024-01-30 |