| NPI | 1659997120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24802) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 201171) |
| 363L00000X Nurse Practitioner (Licence: TN 24802) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2021-12-08 |