| NPI | 1972119816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA RN196869) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 196869) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-11-30 |