| NPI | 1598152274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 0000019907) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3009107) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2021-01-22 |