| NPI | 1588308100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TN 37774) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 37774) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2025-03-24 |