| NPI | 1912472564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO C-APN.0003262-C-NP) |
| 163W00000X Registered Nurse (Licence: TN 225374) | |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2025-12-03 |