| NPI | 1508017393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 13772) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN RN162359) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2013-01-07 |