| NPI | 1255849477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 30949) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 912695) |
| 163W00000X Registered Nurse (Licence: NJ 26NR19758600) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ 26NJ00799700) | |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2022-03-18 |