| NPI | 1770557423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 28797) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL ARNP9206478) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9206478) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2021-04-07 |