NPI | 1164995486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN APN0000023380) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000084613) |
Enumeration Date | 2019-01-09 |
Last Update Date | 2022-03-18 |