| NPI | 1629590369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 22789) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 22789) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2019-04-25 |