| NPI | 1699760199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN RN129000) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 8101) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-04-09 |