| NPI | 1124329420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 12957) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 12957) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 12957) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2019-12-23 |