| NPI | 1477754448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 5424) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN5424) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2014-06-20 |