| NPI | 1508529967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 34974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 227921) |
| 363L00000X Nurse Practitioner (Licence: TN 34974) | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2024-12-05 |