| NPI | 1780939454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN APN17218) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN171561) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2015-10-30 |