| NPI | 1821562901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 25113) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 160411) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-01-11 |