| NPI | 1962143263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-159419) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-159419) |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2024-05-08 |