| NPI | 1063456861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN apn14451) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 14451) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-06-21 |