| NPI | 1407999683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 13954) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 13954) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-07-21 |