| NPI | 1104417914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 27919) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TN 27919) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2022-03-14 |