| NPI | 1952863789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-155422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-155422) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-06-05 |