| NPI | 1508420167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 23536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 23536) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 23536) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2023-04-05 |