| NPI | 1821629320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 30786) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: TN 0000211988) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2022-06-13 |