| NPI | 1972380939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 4009066) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 71014877A) |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2025-09-04 |