| NPI | 1528529476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25645) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 25645) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-05-23 |