| NPI | 1366908782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 25449) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TN 25449) |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024363) | |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: TN 25449) | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2023-10-11 |