| NPI | 1194035485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 217488) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 172832) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 15269) | |
| 163W00000X Registered Nurse (Licence: GA 217488) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2015-03-02 |