| NPI | 1972497378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA C184908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 154744) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-08-15 |