| NPI | 1740499417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 15528) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM R56275) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-09-29 |