| NPI | 1013036961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN RN149487) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 12705) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2018-09-27 |