| NPI | 1447797741 |
|---|---|
| Former Name | SOPHIA ANNE RUNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 22022) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: TN 22022) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2018-07-30 |