| NPI | 1114495058 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TN 29477)  | 
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TN 252428)  | 
| Enumeration Date | 2018-11-08 | 
| Last Update Date | 2023-10-14 |