| NPI | 1487167656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 23375) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 23375) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 23375) | |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2019-02-26 |