| NPI | 1407335490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24667) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 902467) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2019-12-09 |