| NPI | 1316291768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 15836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 128334) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |