| NPI | 1730759028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000027199) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN APN0000027199) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-07-07 |