| NPI | 1871067801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11010020) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL 9436249) |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2021-11-15 |