| NPI | 1740512177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN APN18995) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA RN127592-AP05978) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2015-06-17 |