| NPI | 1992493852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 308091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-145437) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-145437) | |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2024-08-12 |