| NPI | 1548661481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 242864) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 196387) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-22 |